• J Formos Med Assoc · Aug 2024

    Comparative Study

    Tenofovir versus entecavir on recurrence and mortality of hepatitis B virus-related hepatocellular carcinoma after curative therapy.

    • Kai-Chun Chang, Tung-Hung Su, Sih-Han Liao, Tai-Chung Tseng, Shang-Chin Huang, Shih-Jer Hsu, Chun-Ming Hong, Chen-Hua Liu, Hung-Chih Yang, Chun-Jen Liu, and Jia-Horng Kao.
    • Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    • J Formos Med Assoc. 2024 Aug 1; 123 (8): 891898891-898.

    BackgroundTenofovir disoproxil fumarate (TDF) and entecavir (ETV) reduce the risk of hepatocellular carcinoma (HCC) in patients of hepatitis B. This study compared the difference between ETV and TDF on risk of HCC recurrence and mortality in patients with HBV-related HCC after curative intent treatment.MethodsPatients with HBV-related HCC who received HCC treatment (surgery or radiofrequency ablation [RFA]) and underwent long-term ETV or TDF therapy were retrospectively included. Baseline characteristics including age, sex, antiviral therapy, liver reserve, HCC stages, pathology reports and treatment modality were obtained. The risk of tumor recurrence, all-cause mortality, HCC-related mortality, and liver function were compared.ResultsWe identified 390 HBV-related HCC patients with curative intent treatment for HCC and treated with ETV (n = 328) or TDF (n = 62) between January 2011 and December 2020. The median age was 60 years, and 90.7% patients were males. After a median follow-up of 29 months, 186 patients developed recurrent HCC and 111 died. The baseline characteristics were comparable except more ALBI grade 3 patients in TDF group (76% vs. 48%, P < 0.001). Compared to ETV group, TDF users had lower all-cause mortality (adjusted hazard ratio [aHR]: 0.38, P = 0.003), and HCC-related mortality (aHR: 0.23, P = 0.005). Lower recurrence rate was noticed in TDF users after inverse probability of treatment weighting (IPTW). TDF users had improved ALBI grade and FIB-4 index compared with ETV groups.ConclusionTDF therapy is associated with a reduced risk of HCC-related outcomes among patients with HBV-related HCC after curative intent treatment compared with ETV usage.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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